These results corroborate an earlier analysis using a commercial claims data set, which identified few records with harmful algal bloom exposure ICDCM codes 8. Searching the chief complaint text in NSSP more than doubled the number of harmful algal bloom—associated visits, compared with the number that would have been identified by searching on ICDCM codes only. The peak in ED visits during occurred primarily within Region 4, corresponding to a large-scale red tide event in the Gulf of Mexico that persisted during June —November 9.
The occurrence of this peak at the time of a red tide event might explain the higher frequency of chief complaints associated with respiratory symptoms because red tide has been linked to respiratory health outcomes 2,3.
Presumably, these types of large-scale events might cause providers to ask patients about recent harmful algal bloom exposures or cause patients to mention them. The NSSP query development tool made it possible to review a sample of the full chief complaint text without linking to other visit data, which helped to protect patient anonymity.
Increasing awareness so that more patients know to mention harmful algal bloom exposure and more physicians know to ask about harmful algal blooms would enhance understanding of harmful algal bloom—associated ED visits. The findings in this report are subject to at least two limitations. First, some records might have been misclassified or miscoded.
For example, the query development tool identified some records with a chief complaint that seemed unrelated to harmful algal bloom exposure e. In addition, it is unknown what occurred during the ED visit between when the chief complaint was assigned at triage and when the final diagnosis was determined.
Some patients might have described a harmful algal bloom exposure, but medical personnel might have ruled it out as the primary reason for diagnosis. Despite these limitations, however, these analyses provide information of how often exposure to a harmful algal bloom is documented during ED visits through diagnostic codes and chief complaints. These findings provide information about how harmful algal bloom exposure can be identified through syndromic surveillance ED visit data and potentially used to identify the extent of illness from harmful algal bloom exposure in the United States.
As the frequency and geographic extent of harmful algal blooms increase, it is important for health care providers to discuss and document harmful algal bloom exposures and health effects during medical visits to ensure proper patient treatment and help patients understand how to prevent exposure in the future.
As access to information from electronic medical records for research improves, better documentation of harmful bloom exposures and illnesses can help support a more accurate assessment of their acute public health impact. With better documentation, electronic health record systems with longitudinal data could potentially provide data for monitoring long-term health effects from these exposures, the extent of which are largely unknown. All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest.
No potential conflicts of interest were disclosed. This data subset helps users to iteratively develop queries with inclusion and exclusion terms to capture only the records of interest. Some NSSP sites do not contribute data to this data source. Department of Health and Human Services. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.
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Competition will begin on January 1st of each calendar year and will end on December 31st. All scores must be returned to NRA and postmarked by January 15th. Firing may be done any time after score reporting forms are received from the Competitive Shooting Division. All team members must enter as individuals. See each match for award schedule. Minimum of two competitors in a category for an award to be given.
Complete the entry form attached and return to the Competitive Shooting Division. You will receive score reporting forms to record the match scores. Return completed score reporting forms to: The NSSP Coordinator Darell Freeman at [email protected] A return email will supply you with mailing information for your entry fee. Target acquisition is the responsibility of the competitor. State of Alaska Naghe nduniyu! Control Time from Harvest to Temperature Control The harvester must place shellstock under temperature control 3 within 5 hours after the first shellstock harvested is no longer submerged; and For each lot of shellstock harvested, Record the time and air temperature when the first shellstock harvested is no longer submerged; and Record the time and temperature of shellstock when placed into under temperature control.
If closed, an area remains closed for a minimum of 14 days.
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